1. Field of the Invention
The present invention relates generally to a device for harvesting skin and excising burns, and in particular to a dermatome with adjustable guards to control the width and depth of the cut without interruption of the medical procedure.
2. Brief Description of the Related Art
A dermatome is a medical instrument that has used since the 1940's when it was developed for a split thickness skin graft. A skin graft is a patch of healthy skin that is harvested from one area of the body or donor site to cover a damaged or skinless area of the body. Surgeons recently have been using a dermatome for excising burn wounds, especially over relatively flat surfaces such as the back, chest, and lower extremities.
Depending on the area of the body, the extent of the damaged tissue, and other factors, the width and depth of the skin being harvested or burned tissue being excised will vary. To allow for this variance, the prior art dermatomes comprise attachable guards that control the portion of the blade that is exposed to the skin. The greater the portion of the blade exposed laterally, the greater the width of the cut. The greater the height of blade exposed from the front edge of the device, the greater the depth of the cut. To adjust the width of the cut during the medical procedure, however, the guard has to be mechanically changed. This changing process consists of stopping the medical procedure, disconnecting the dermatome, detaching the guard (e.g. unscrewing the guard from the dermatome), attaching the new guard (e.g. screwing the guard to the dermatome), and resuming the medical procedure. This process is very time consuming, which wastes valuable operating room time.
In addition, prior art dermatomes are not designed for both harvesting skin and excising burned tissue. Thus, in order to excise burns, several runs at the maximum blade depth of the dermatome is often required. This process can also be very time consuming and thus costly to the patient.
Many of the prior art dermatomes are air-powered, thus relying on an air connection, which requires a long, heavy tubing that interferes with the surgeon and can clutter the operative field. Because of the pressure exerted on the dermatome, the prior art dermatomes are generally made of steel or other strong materials. As a result, the dermatomes are heavy and often difficult to maneuver. It has also been observed that the blade of the prior art dermatomes often becomes dull very quickly. On average, after four harvests of skin, or two excisions of burns, the blade must be changed. The blade changing process involves disconnecting the dermatome, detaching the guard, changing the blade, reattaching the guard, and then reconnecting the dermatome.
Moreover, prior art dermatomes designed to excise burned tissue utilize blades that have been in practice for over 60 years. The blades are known for frequently digging into the skin during excision creating lacerations that must be repaired. In addition, they produce ragged edges that can be cosmetically unsightly.
It would therefore be desirable to develop a dermatome with adjustable guards to control both the width and the depth of the cut without interruption of the skin harvesting or burn excision procedure.
It would also be desirable to develop a dermatome that is capable of excising damaged tissue with a single pass.
It would also be desirable to develop a dermatome that is lighter in weight, battery-powered, and has a blade that will allow multiple harvests and excisions without necessitating a blade change.